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Biomedical subjects

J Elford

Publications and source records attributed to J Elford.

104 records · Page 6Linked to original sources
PubMed1990

New initiatives in a district AIDS counselling unit, 1988-89.

This paper describes the workload of the AIDS Counselling Unit in Hampstead District Health Authority during its second year of service. Between April 1988 and March 1989, the average number of patients seen each month by the Unit doubled. It is anticipated that the caseload in the district will continue to increase, both among those with human immunodeficiency virus (HIV) infection and those without. New initiatives were developed within the district during the year. These included a new inpatient facility for patients with the acquired immunodeficiency syndrome (AIDS), the appointment of a designated HIV/AIDS consultant, and counselling services for people attending the antenatal clinic as well as those entering drug trials. Appropriate counselling services will need to be established in other health districts to meet local demand.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Migration and geographic variations in ischaemic heart disease in Great Britain.

The British Regional Heart Study seeks to explain the geographic variations in cardiovascular disease in Great Britain. A strong geographic gradient in the risk of a major ischaemic heart disease (IHD) event was found in 7735 middle-aged men who were followed up for 6.5 years. Regardless of where they were born, men examined in Scotland experienced the highest IHD risk, while those examined in the South of England had the lowest. The place of examination (ie, residence) was a more important determinant of the risk of a major IHD event than the place of birth. It seems unlikely that the geographic differences in IHD risk among middle-aged British men can be directly explained by their genetic inheritance or by their prenatal and postnatal diet.

Adult↗
PubMed1989

Prediction of progression to AIDS by analysis of CD4 lymphocyte counts in a haemophilic cohort.

Serial CD4 lymphocyte counts were recorded in 112 anti-HIV-positive haemophiliacs who were followed for up to 8 years after seroconversion. The patients remained at low risk of developing AIDS until their CD4 lymphocyte count fell to 0.25 X 10(9)/l. From this point, the risk increased as their count approached zero. Using this result and on the assumption (which is evaluated) that the underlying trend over time in CD4 lymphocyte counts is linear, the predicted rate of progression to AIDS was calculated for the cohort. It was estimated that 73% (95% confidence limits 60-86%) of the cohort will develop AIDS within 15 years of HIV-seropositivity. During 8 years of follow-up, this cohort had shown similar rates of progression to AIDS to other cohorts--haemophilic and otherwise--suggesting that this estimate may well have general applicability. The method described could be used to plan the provision of health-care resources for groups of anti-HIV-positive patients as it allows the number of new cases of AIDS to be predicted year by year, even when the patients' dates of seroconversion are unknown.

Acquired Immunodeficiency Syndrome↗
PubMed1989

The natural history of human immunodeficiency virus infection in a haemophilic cohort.

112 haemophilic patients infected with HIV were followed up with clinical and laboratory assessment between 1 December 1979 and 30 November 1988. Sixty-six (59%) of the patients developed HIV-related clinical symptoms and 22 (20%) developed AIDS. Twenty (18%) of the patients developed p24 antigenaemia. Amongst the 59 patients whose date of seroconversion could be estimated the calculated 8-year cumulative incidence of AIDS was 40% (symptoms 73%). For the whole cohort of 112 patients, the median slope of linear regression of the absolute T4 lymphocyte count was steeper for those with AIDS (-0.113 x 10(9)/l per year) than for those without AIDS (-0.054 x 10(9)/l per year) (P less than 0.02). While 15 cases of AIDS developed during 58 patient-years of follow up after falling below a T4 lymphocyte count of 0.2 x 10(9)/l, only two cases occurred during 450 patient-years before reaching this count. Thus the decline of the T4 lymphocyte count to 0.2 x 10(9)/l may be an appropriate additional end-point for the assessment of new treatments for asymptomatic patients infected with HIV.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Workload of a new district AIDS counselling unit, April 1987 to March 1988.

The Hampstead district AIDS counselling unit in London was opened in January 1987. It is staffed by a clinical psychologist, a social worker, and an administrator. From April 1987 to March 1988, 141 new patients and their relatives were referred from a range of clinical departments and 544 counselling sessions were provided. In addition, 666 staff consultations were organised to help colleagues manage some of the psychosocial problems of patients. An increase in demand during 1988-89 and a need for additional resources are anticipated. A strong case is seen for training other members of health care teams so that they may counsel patients with AIDS without referring them to the unit.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Moral and social aspects of AIDS: a medical students' project.

The rising number of cases of AIDS in Great Britain has important implications for all those who work in the health services. A group of pre-clinical students at the Royal Free Hospital School of Medicine, London, undertook a project in which they explored some of the sociological and epidemiological aspects of AIDS. Particular attention was paid to any stigma that may surround the disease. The moral definition of the disease pervaded all areas of enquiry during the project. It is suggested that sound management of AIDS patients and those who are HIV antibody positive, will require both health care staff and students to carefully consider their own beliefs regarding the disease and those most at risk.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Population studies: an integrated course in epidemiology and sociology for medical students.

At the Royal Free Hospital School of Medicine, London, an integrated course in epidemiology and sociology for preclinical students was introduced in 1979. The course--Population Studies--is taken by the 100 second-year medical students in the summer term before they enter their clinical years. It occupies one full day and one half day each week for 8 weeks--approximately 80 hours of tuition. Population Studies is unusual in two respects. Firstly, it introduces a substantial amount of epidemiology into the preclinical curriculum. And, secondly, this is the only London medical school to integrate the teaching of sociology and epidemiology into the one course.

Education, Medical, Undergraduate↗
PubMed1983

Diabetes mortality: new light on an underestimated public health problem.

Mortality from diabetes is underestimated four- to fivefold by methods of analysis of death certification data which use only underlying cause of death. This problem is partially overcome by coding all conditions mentioned on death certificates. For a sample of deaths in England and Wales over the years 1972-1977, the observed proportion of certificates with specific underlying causes of death for certificates mentioning diabetes was compared with the expected proportion for all certificates. These observed/expected ratios were significantly increased in each sex for circulatory diseases and were significantly reduced for neoplasms. For 'nephritis' they were also increased, especially below 45 years of age. These results were confirmed by an analysis of underlying cause of death in a cohort of nearly 6,000 members of the British Diabetic Association. Of the 2,134 deaths in this cohort, diabetes was not mentioned on 33% of the death certificates. For the period 1972-1977, death rates for circulatory diseases associated with diabetes increased by 6% for males but remained constant for females.

Adolescent↗
PubMedDate not supplied

Sexually transmitted diseases in prostitutes in Moshi and Arusha, Northern Tanzania.

Sexually transmitted diseases are thought to be important in facilitating transmission of HIV in sub-Saharan Africa. This study reports the prevalence of several sexually transmitted diseases in 106 prostitutes in Arusha and Moshi Northern Tanzania. The seroprevalence of HIV was 73% compared with 3% for local blood donors. Over half (51%) of the subjects had evidence of N. gonorrhoeae infection. Seventy-four per cent had a positive TPHA and 27% a positive RPR. Of 47 subjects tested 12 (25%) had Chlamydia trachomatis antigen detected in endocervical swabs. No significant statistical association was found between the presence of any of the STDs investigated and HIV seropositivity.

Adolescent↗
PubMedDate not supplied

Increasing workload of an HIV/AIDS counselling service in a London teaching hospital, 1990-91.

The number of new patients referred to the HIV/AIDS Counselling Unit at the Royal Free Hospital, London, increased from 926 in 1989-90 to 1450 in 1990-91. Follow-up contacts nearly doubled during the same period of time. Growing demand for HIV testing as well as the shift to the treatment of HIV as a chronic condition increased the workload of the HIV/AIDS counsellors.

AIDS Serodiagnosis↗